New regulations on transferring patients between healthcare facilities under health insurance in Vietnam

New regulations on transferring patients between healthcare facilities under health insurance in Vietnam

- The transfer of patients between healthcare facilities covered by health insurance in Vietnam is executed in accordance with the legal provisions on medical examination and treatment.

- Cases of transferring patients between healthcare facilities covered by health insurance in the correct order include:

+ Transferring patients between healthcare facilities within the same level of medical examination and treatment, from primary healthcare facilities to basic healthcare facilities, from basic healthcare facilities to specialized healthcare facilities according to professional requirements, the patient's condition or beyond the capacity of the healthcare facility, except for cases stipulated at point dd, clause 2, Article 9 of Circular 01/2025/TT-BYT and Article 5 of Circular 01/2025/TT-BYT;

+ Transferring patients from primary healthcare facilities to specialized healthcare facilities in cases beyond the capacity of the basic healthcare facility at the provincial level;

+ Transferring patients who have been stabilized from specialized healthcare facilities to basic or primary healthcare facilities, transferring patients from basic healthcare facilities to primary healthcare facilities for further treatment and monitoring;

+ Transferring patients from specialized or basic healthcare facilities back to initial health insurance facilities for treatment, management, and monitoring of chronic diseases as stipulated in Article 10 of Circular 01/2025/TT-BYT;

+ Transferring patients between healthcare facilities for those with chronic diseases or long-term treatment according to the list of diseases set out in Appendix III issued together with Circular 01/2025/TT-BYT, the healthcare transfer form is valid for 1 year from the date recorded on the transfer form and is executed according to the regulations at point b, clause 3, clause 4, and clause 5, Article 5 of Circular 01/2025/TT-BYT;

+ In cases where the health insurance cardholder goes for medical examination and treatment on their own not following the regulations in Articles 26 and 27 of the Health Insurance Law and falls under the cases stipulated at points e, g, h (except cases covered 100% at points e and h) clause 4, Article 22 of the Health Insurance Law and then is transferred by the healthcare facility to another facility as per professional requirement;

+ In emergency cases, after emergency treatment, the patient is transferred to inpatient treatment at the healthcare facility that provided the emergency treatment or transferred to another healthcare facility for continued treatment as per professional requirements or transferred back to the initial healthcare registration facility after stabilization.

For detailed content, refer to Circular 01/2025/TT-BYT effective from January 1, 2025.

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